Intra-articular corticosteroids. An updated assessment.

Area of Science:

• Rheumatology
• Orthopedics
• Pharmacology

Background:

• Local corticosteroid injections are frequently used for various arthropathies and soft tissue conditions.
• Their efficacy in suppressing inflammation, such as rheumatoid synovitis, is well-documented for extended periods.
• Evidence regarding their impact on retarding joint erosive changes is limited.

Purpose of the Study:

• To evaluate the role and safety of local corticosteroid injections as an adjunct therapy.
• To assess the effectiveness in managing rheumatoid arthritis, connective tissue diseases, and osteoarthritis.
• To review the potential adverse effects and long-term consequences of intra-articular steroid use.

Main Methods:

• Review of existing literature and clinical studies on corticosteroid injections.
• Analysis of controlled trials in osteoarthritis of the hip and knee.
• Examination of case reports and animal studies concerning corticosteroid arthropathy.

Main Results:

• Corticosteroid injections effectively suppress synovitis for up to three months.
• Limited evidence supports their ability to slow joint erosive changes in rheumatoid arthritis.
• Modest and transient benefits observed in hip and knee osteoarthritis, though useful for acute exacerbations.

Conclusions:

• Intra-articular corticosteroids are a safe and effective adjunct for managing inflammatory arthritis and soft tissue rheumatism.
• They should complement, not replace, foundational treatments like physical therapy and disease-modifying drugs.
• Adverse effects are rare, with infectious arthritis and cartilage attrition being infrequent complications.